Zusammenfassung
Die Persistenz einer Liquorrhoe bei einer Oto-basisfraktur ist nach den Angaben der
Literatur ein seltenes Ereignis. Von 1989 bis 1992 wurden in der Universitäts-HNO-Klinik
Mainz vier Fälle mit otobasaler Fraktur und Durazerreißung operiert, die noch nach
mehreren Monaten erstmalige oder persistierende Symptome einer offenen Schädelbasisverletzung
aufwiesen. Der Verlauf dieser otobasalen Frakturen wird anhand den Erkenntnissen der
Literatur analysiert.
Summary
In the literature the persistence of cerebrospinal Liquorrhea after temporal bone
fractures is a rare event. Between 1989 and 1992 four cases of temporal bone fractures
with dural involvement were operated at the University ENT Department Mainz. These
temporal bone fractures showed delayed or persistent symptoms of dural lacerations
between three and sixty months after head injury. During operation we found larger
bone-dura defects (1 - 1.5 cm in diameter) and brain herniations in all cases. Strohm stated that only in rare cases a temporal bone fracture produced a larger gap in
the tegmen tympani or antri. Therefore, we assumed that in our cases such larger bone-dura
defects were caused by a gradual widening of the bony gap by a local elevation of
intracranial pressure. Ferguson described this phenomenon in cases with spontaneous cerebrospinal Liquorrhea. Our
cases showed that the cessation of cerebrospinal Liquorrhea is not a reliable sign
of a healed dura defect. Therefore we propose that temporal bone fractures should
be controlled closely in the first twelve months after trauma even if the dura defect
seems to close spontaneously.
Schlüsselwörter
Felsenbeinfrakturen - Oto-Rhinoliquorrhoe - Hirnprolaps
Key words
Temporal bone fractures - Oto-rhino-Liquorrhea - Brain herniation
